Athlete level, sport-type, and gender influences on training, mental health, and sleep during the early COVID-19 lockdown in Malaysia

Abstract

Purpose: We evaluated the extent of changes in training practices, recovery, mental health, and sleep patterns of athletes during the early COVID-19 lockdown in a single country-cohort. Methods: A total of 686 athletes (59% male, 41% female; 9% World Class, 28% International, 29% National, 26% State, 8% Recreational) from 50 sports (45% individual, 55% team) in Malaysia completed an online, survey-based questionnaire study. The questions were related to training practices (including recovery and injury), mental health, and sleep patterns. Results: Relative to pre-lockdown, training intensity (-34%), frequency (-20%, except World-Class), and duration (-24%-59%, especially International/World-Class) were compromised, by the mandated lockdown. During the lockdown, more space/access (69%) and equipment (69%) were available for cardiorespiratory training, than technical and strength; and these resources favoured World-Class athletes. Most athletes trained for general strength/health (88%) and muscular endurance (71%); and some used innovative/digital training tools (World-Class 48% vs. lower classification-levels ≤34%). More World-Class, International, and National athletes performed strength training, plyometrics, and sport-specific technical skills with proper equipment, than State/Recreational athletes. More females (42%) sourced training materials from social media than males (29%). Some athletes (38%) performed injury prevention exercises; 18% had mild injuries (knees 29%, ankles 26%), and 18% received a medical diagnosis (International 31%). Lower-level athletes (e.g., State 44%) disclosed that they were mentally more vulnerable; and felt more anxious (36% vs. higher-levels 14%-21%). Sleep quality and quantity were "normal" (49% for both), "improved" (35% and 27%), and only 16% and 14% (respectively) stated "worsened" sleep. Conclusion: Lockdown compromised training-related practices, especially in lower-level athletes. Athletes are in need of assistance with training, and tools to cope with anxiety that should be tailored to individual country requirements during lockdown situations. In particular, goal-driven (even if it is at home) fitness training, psychological, financial, and lifestyle support can be provided to reduce the difficulties associated with lockdowns. Policies and guidelines that facilitate athletes (of all levels) to train regularly during the lockdown should be developed.

Keywords: elite athlete; injury; mental health; periodisation; recovery; remote training.

FIGURE 1

Distribution of respondents based on athletes’ residence in Malaysia.

FIGURE 2

Training intensity depicted by athlete classification, sport-type, gender, and total cohort (n = 665). (Question: Do/did you maintain your pre-lockdown intensity for sports specific training (practicing your sport) during the lockdown? Can you estimate how much in percentage? (100% represents the same intensity as before the lockdown). Note: The violin plot includes a 5-point summary, which represents the number in dataset: minimum (lower extreme); 25% percentile (first dashed line/lower quartile); median (black thick line); 75% percentile (second dashed line/third quartile); and maximum (upper extreme). The thin dotted line across all charts/violins represents average intensity.

FIGURE 3

Training frequency (< or ≥ 5 sessions/week; (A)) and duration (< or ≥ 60 min/session (B)) based on athlete classification, sport-type, gender, and total cohort, before and during lockdown; data are column % of respondents (n = 661). Percentage, within athlete classification, sport-type, and gender represents “yes” answer, relative to “no” answer. WC, world-class; INT, international; NAT, national; ST, state; REC, recreational. *Significantly higher (or significant contributor to the relationship); superscript letter represents significantly higher than ^A/B/C/D/E; all at p < .05, based on residuals of >1.96.

FIGURE 4

Training space/access (A) and equipment (B) for technical, cardiorespiratory, and strength by athlete classification, sport-type, gender, and total cohort (n = 660). Percentage, within athlete classification, sport-type, and gender, represents “yes” answer, relative to “no” answer. WC, world-class; INT, international; NAT, national; ST, state; REC, recreational. *Significantly higher (or significant contributor to the relationship); superscript letter represents significantly higher than ^A/B/C/D/E; all at p < .05, based on residuals of >1.96.

FIGURE 5

Injury prevalence as shown by muscle areas Percentage, within athlete classification, sport-type, and gender, represents “yes” answer, relative to “no” answer. WC, world-class; INT, international; NAT, national; ST, state; REC, recreational. *Significantly higher at p < .05 (within the specific comparative variable).

FIGURE 6

Financial challenges during lockdown based on athlete classification, sport-type, gender, and total cohort; data are presented in percentage. ^CDSignificantly higher than National and State, *significantly higher at p < .05 (within the specific comparative variable).